How to Write a Realistic Birth Plan

Sarah Austin wanted to have a natural birth without medication, so she and her partner drew up a two-page birthing plan at the urging of the nurse-midwife. This included the possibility that she could have a caesarean section, and how she hoped that it would be dealt with. “I considered a caesarean section not the desired outcome,” Austin says, “but a possible outcome.”

This opportunity became a reality when Austin had a fever after 24 hours of active labor. “We talked about whether a caesarean section was the right step and we decided it was,” Austin says. She was “disappointed that this happened,” and her recovery was more difficult than it could have been, but she says she “did not feel controversial about this decision.”

“It’s an important difference,” says Megan Brown, doula and founder of Emerge Birth Services , an Atlanta-based birth preparation and support company. “Focusing on results is what can set mom and family up for failure,” says Brown, especially when there is so much talk about the “best” births and the “right” steps to prepare for them.

“Women are told to just use positive thinking to” trust birth “and” trust your body, “- says Pam England, the creator of a series of classes on childbirth” be born from within , “whose first birth (it was assumed that they should be at home) have ended in failure. C-section. This kind of “magical thinking”, says England, directly contradicts the medical obstetric industry in the United States, where 40% of women give birth by caesarean section. So, if women have a birth different from what they hoped for, they often blame themselves for being “weak” or “unlucky,” says England.

And that frustration – or even trauma – can put a woman at risk of developing perinatal mood disorder or anxiety disorder .

This is why England and Brown, whose classes are based on the Born From Within model, recommend that you clearly understand what you can and cannot control and prepare for it all.

Take a Maternity Training Course

“A childbirth preparation course is a great way to prepare for childbirth,” says Brown. She recommends looking for classes that offer extensive preparation for childbirth, as opposed to focusing on just one method or those classes that are taught in hospitals. “Hospital birthing classes tend to teach parents how to be good patients and good medicine. A non-affiliated maternity course can go a little deeper and spend more time mentally and emotionally. ”

Plan your support

“Make a list of what’s really important to you and ask if your service provider will abide by those rules,” says Brown. If they don’t? “It’s never too late to change providers.” And make sure your healthcare provider “not only verbally expresses your wishes, but actively encourages you to be supportive to make them come true,” recommends Lauren Abrams, CNM, director of midwifery at Mount Sinai Hospital in Manhattan.

“If you want to give birth without treatment, the first thing you can do is get a doula,” Abrams says. According to Emily Oster, Ph.D., author of Expecting the Best: Why Conventional Beliefs About Pregnancy Are Wrong, and what you really need to know, this study backs it up . In one study, women were randomly assigned to a doula when they were admitted to the hospital, while other women gave birth without it. “Women who were assigned to doula had lower levels of epidural anesthesia and caesarean section,” Oster says.

Places to find a doula include doulamatch.net , the Organization of Obstetrics and Postpartum Care Professionals (CAPPA), and DONA International . Often new or learning doulas who are still finishing their certification hours will offer lower fees.

Brown says another important tool for a non-drug or vaginal birth is to prepare the baby for labor. She recommends using the methods and resources at spinningbabies.com and adds that “every pregnant woman planning to give birth needs to focus on the optimal fetal position.”

Focus on your surroundings and survival tools

“You cannot control your birth as it unfolds and progresses,” says Brown. “But you can control your environment – who is in the room, what tools you use. Ultimately, you create an environment that is perfect for childbirth and childbirth, and then you simply allow the birth to unfold as needed. “

Additionally, Brown recommends researching and practicing several different pain relief treatments so that if one doesn’t work for you during labor, you have other options to turn to.

Treat your birth plan as the start of a conversation.

When you consider the biologically monumental task that you are solving – growing a person within you and then pushing him or her out of a rather small hole in your body and out into the world – it seems like you can actually plan how it goes. a little stretch.

“A birthing plan is a good start,” says Brown. “You can say, ‘This is what we are planning, but we understand that this is just a set of guidelines that may or may not apply when labor begins.” Then use that as a way to start conversations with your pre- birth providers so you can make sure they are supportive of your wishes and will work to help you fulfill them.

Be concise and focused

“Start by saying, ‘My birthing plan is to do my best,” England recommends. “Then pick one thing that is most important to you and ask for it, for example,“ I don’t want to be offered drugs every time someone walks into the room. I will ask for medicines if I need them. ” The shorter the plan, the more likely your healthcare providers will read it and help you with your work. ” Austin’s plan included a sentence: “I don’t want anything done to me without information.”

Think about plans B and C

“What you really need is a framework for childbirth,” recommends Oster, who, in addition to researching childbirth and childbirth as an economist, has gone through it twice. “It’s like a game tree:” If this happens, then I would like to do it. “

Think about one or two things that you hope won’t happen and then get ready for them, England recommends. “Some people are afraid of needles and do not want to have intravenous injections. Some people are afraid of a long labor. ” Opening up to thinking about how you will handle these situations if they arise (perhaps learning some breathing techniques if your anticipated epidural is delayed, for example) will help them feel less intimidated and help you maintain a sense of control. …

This was Austin’s approach to caesarean delivery. “Discussing this issue beforehand was very important,” Austin says. “We thought about how to make it as enjoyable as possible.” Looking back, she says, “I feel like I can reconcile what was not my first choice with what I made an informed choice.”

This is why Brown takes her female students through all aspects of Caesarean section and why she calls it Caesarean section and not Caesarean section. “I believe that regardless of whether you give birth by natural means or by caesarean section, a woman will still give birth to her child. Although this is a major abdominal surgery, understanding what the birth looks and feels like allows you to make that decision without much fear. ”

Expect uncertainty

“In our society, everyone wants to ‘keep their shit together,’ says England. “We want to look good, know what we are doing, be in the know, and that everything goes exactly as planned. At birth, we should not strive for this. We must look for the moment when we do not know what to do, when we do not know what to expect from ourselves. ” The very fact that you are open to uncertainty – even if you expect it – can help you become less fearful if it does.

And when you think about how birth changes your life, it becomes clear that it will be accompanied by a range of experiences and emotions, and not just follow the Hollywood script that we’ve all come to expect.

“Even with hundreds of years of obstetrics research, we don’t know where labor starts,” says Abrams. “So this is unpredictable and you have to learn to let go. It will happen when it happens. It will be what it should be. “

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